Provider Demographics
NPI:1871658237
Name:MURRAY, JOAN EILEEN (OTR, CHT)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:EILEEN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 GROVE AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2322
Mailing Address - Country:US
Mailing Address - Phone:516-295-5002
Mailing Address - Fax:516-295-2720
Practice Address - Street 1:123 GROVE AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2322
Practice Address - Country:US
Practice Address - Phone:516-295-5002
Practice Address - Fax:516-295-2720
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3053-1225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ68871Medicare ID - Type UnspecifiedOT-INDEPENDENT PRACTICE